As the Director of Behavioral Health for Lakeland Regional Health, Alice Nuttall oversees the team of physicians, nurses, and qualified mental health professionals for both the inpatient behavioral health service and the outpatient behavioral health clinic. She is an involved member of the Polk County community, serving as the co-chair for the Polk Vision Exploratory Board. Nuttall, a Registered Nurse, has a degree in business as well as neuroscience psychology. Born in Lakeland, she left for college and lived in Nashville, Tennessee for over two decades. She has worked as a nurse and behavioral health professional across many areas including substance abuse, addiction, residential, and more. She was thrilled to be recruited back to her hometown just under two years ago.
“This is my life’s passion and greatest joy to be able to do this kind of work and work with the fine individuals I do every day,” said Nuttall. “We always find that there are a lot of mental health opportunities and concerns, but with COVID-19, it has increased the importance, I feel, of the work that we do every single day.” Nuttall can vividly remember the course material of her Health Psychology class as a freshman in college at Vanderbilt University. “It was about the intersection of the human body, our physiological health, with our emotional health, and our mental wellness.”
Throughout all of the work she’s done from being a critical care nurse working in the Neuro ICU working with head trauma patients at Vanderbilt, inpatient work, outpatient, with children and adults, she said, “In all of these different roles, the same themes continued to come up. I have a passion and calling for helping people in crisis, and advocating for them when they can’t advocate for themselves. Also, I find myself having a voice on whatever team that I’m on, to make sure we always care for and treat the whole person.” We talked to Alice Nuttall about how nutrition and exercise habits affect the way we feel and applicable ways to make changes for our overall health, mind and body.
Food = Mood
Can what you eat affect your mental health? “Absolutely,” said Nuttall. “I like to think of it as food is related to your mood. [...] Your brain is working and operating and is a very fine-tuned piece of equipment and it operates 24/7, 365, all the time for your entire life. We need to make sure that we’re thinking about quality, well-balanced nutrition, to help us feel the best that we possibly can.”
First, let’s talk about the neurotransmitter, serotonin. According to Nuttall, serotonin regulates mood, happiness, anxiety, and sleep. “Ninety percent of the serotonin that is produced in your body is produced in your GI tract,” she explained. From your mood, feelings, inhibitions, and sleep, “All these things that intertwine to help us feel balanced, are coming from your belly,” said Nuttall. “There is certainly a link.”
Eating in a way that promotes good gut health will produce higher levels of serotonin. Adversely, Nuttall says there are hormones that you do not want as much of, like cortisol. “Stress causes cortisol release. Cortisol increases appetite and can cause someone to overeat. High cortisol also increases food cravings for sugary or fatty foods. Stress, therefore, increases cravings for unhealthy foods,” said Nuttall.
All Things in Moderation
Nuttall doesn’t promote one specific diet or exercise regiment over another. “I think the thing that is most important is balance,” she said. “All things in moderation can be okay. One of the things detrimental to people’s mental health is any extreme.” Bodies are different. “Our needs are different, our ages are different and we all need carbs and healthy sugars to live and to have a good metabolism, but I think you want to have a good balance.”
A good rule of thumb is to stick to the outside perimeter of the grocery store as much as possible and keep the refined and processed food in moderation. “By limiting things completely, you start to mess with your mind and you may even crave it more.”
During COVID-19, people have started cooking at home now more than ever. Nuttall suggested, “For every recipe you try that may be on the upper end of the pyramid – if you’re trying a new cookie recipe, a cake, or something in that goody category – make sure that two of your other recipes or items that you’re preparing that day are on the healthier spectrum.” For example, during a recent dinner with close friends, Nuttall and her family grilled chicken and opted for a cauliflower option of potato salad and coleslaw with homemade dressing. “I was really impressed with how delicious the meal turned out. It felt like we were eating barbeque chicken with potato salad and coleslaw, but it was so much better because we used good, wholesome ingredients.”
Do a Mind Flip
Take a moment and give yourself a score between one and ten for how healthy and nutritious you feel like your diet is – one being extremely unhealthy and ten being perfect balance, getting everything your body needs every day.
Now, give yourself a score from one to ten based on exercise.
Is your face getting hot with embarrassment or apprehension to score yourself? Are you already maligning your score? Don’t worry, you’re not being diet and exercise shamed – Nuttall uses this method to teach an important mind flip. Our immediate tendency is to think of our score and ask ourselves why it isn’t closer to a ten. “You need to flip your mind and think about it as, why am I not a zero? What am I doing right today, currently, in the moment that has made me a little bit closer to my goal?” Think of everything you do regularly that leads to that score, and make it a goal to do a little bit more of that every week. Trying to force a new habit can be counterintuitive, said the Director of Behavioral Health. “I need to set my goals of doing that one additional day this week. If I have it be incremental and small, that will help me.”
This is a form of positive psychology that will set you up for success in reaching your goals. “If you do this mind flip and you perceive your current behavior and current status as the glass half full versus glass half empty – you are already more successful, and you are going to be more successful in those next little incremental goals that you’ve set for yourself,” said Nuttall.
If you stretch or do yoga twice a week, try to add an extra day next week. If you walk your neighborhood for 30 minutes each evening, try doing it for 40 minutes next time. “When we talk about goals and making a change, start with something small that you can keep and don’t do too much right away.” Nuttall explained why the approach of incremental changes in favor of a complete habit overhaul tends to work better for people. “If I were to decide, I am going to go extreme and cut out all carbs, all processed food, all caffeine, I’m not going to drink any alcohol, I’m only going to drink water and I’m going to start tomorrow at 8 a.m. I’m going to be more likely to fail because those goals are extreme. Even if I do stick to it for a couple of days, there will be a sense of almost white-knuckling it.”
Track the Change, Be Mindful
Nuttall recommends keeping track of how you feel after what you eat or a small change you’re making, using mindfulness and journaling. This could mean clicking out your thoughts on the notes app of your phone or jotting it down on a legal pad.
Between days 14 and 21 is when a habit sets in according to Nuttall. “Habit is when your behavior through routine and repetition becomes incorporated into your daily living. It may be sooner than when the habit is as strong as it could be, you’ll probably start seeing benefits and you may not have changed anything else about your diet.”
Maybe your goal is to pack your lunch instead of grabbing fast food, or to consume less soda, drink more water, or to remove sugar from your morning coffee. Do that for a week to ten days and take note of how you feel, she encouraged. “Typically, what we find is if you track that and start to see trends and connections and you use that mindfulness to make connections, that will fuel your next positive change.”
Self-Care is Simple
Nuttall’s approach to healthcare is holistic. Remember, there is an intersection between mind and body. If Nuttall is trying to help a patient through a stressful time, she will discuss reinforcing healthy habits including balanced nutrition, sleep (not only the hours, but restful, quality sleep), and some form of activity every day.
With all that is going on in the world and our lives, it might not be the right time to train for a marathon, but Nuttall said, “If you get out and walk back and forth around your block one time today – those small goals – with that amount of physical activity you start to see health benefits.” Try these same kinds of changes within your nutrition too. Practice mindfulness and deep breathing.You may think meditation and deep breathing aren’t for you or maybe you don’t have time. Small changes.
When Nuttall wakes up in the morning and hears her alarm go off, she likes to hit the snooze button. For those ten minutes, before the alarm goes off again, she doesn’t pick up her phone and tries to keep her mind clear of worries and to-do lists. “I try to take ten cleansing deep breaths and focus on something positive, focus on something good. Imagine a happy place – somewhere that brings you joy and peace. What are you looking forward to that day,or what from the day prior was a bright spot – even if it’s very small like a one- or two-word interaction with someone you care about?”
Like with the other small habits you’re adopting, track that for a couple of weeks. “It will improve your heart rate, your blood pressure, and your stress hormones. Therefore, it impacts all the other things in a healthy way. You’ll crave less bad foods, you’ll crave good things, and you’ll make better decisions because you’ll be more centered.”
Give Yourself Grace
Maybe you skipped out on exercise yesterday or ate one too many powdered donuts or binged the entire season of Unsolved Mysteries on Netflix. Nuttall says to acknowledge that you didn’t make an ideal choice and work to not repeat it in the future.
“You don’t want to villainize or beat yourself. This has been one of the hardest things to process and figure out than we’ve ever had before, all at one time,” said Nuttall. “The human body and the human spirit feel more confident and comfortable when we know what to predict when things are more certain around us.”
“Especially during COVID times, we all need to give ourselves a little bit of grace,”she said. Give yourself that grace, take a balanced approach moving forward, do a mind flip, make and track incremental changes, and be mindful.